John Moloney (Laois-Offaly, Fianna Fail)

I also welcome these few minutes to speak in this debate and to support the Government amendment. I welcome the fact that the Minister has made it clear that this is about patient safety, not just about hospital buildings and where hospitals should be located. I welcome the fact, particularly arising from the Leas Cross report, that we will at last have statutory inspections and not pre-planned visits. As a member of a former heath board, I often witnessed the nonsense of notifying the local hospital or nursing home of the possibility of a visit. At last we have seen a robust attack on the service area to ensure that the Minister's commitment will be honoured and I welcome that. It is important that the legislation coming before the House will strengthen regulation and inspections and this will go a long way to assuring the public about quality and safety. People are concerned at the lack of accountability. They hear of incidents occurring in nursing homes and it causes great alarm.

It is important to reflect on what the Minister has said about the numbers of patients presenting for surgical procedures in some hospitals. It is important that we realise it is not just about flying the county hospital flag. It is important that patient safety is taken into account by way of the levels of procedures provided in some institutions. Recent figures indicate the proportion of patients treated by consultants doing more than 50 procedures per year has increased from 23% in 1997 to 58% in 2003. We must welcome this. Figures recently released indicate that 308 of 1,800 patients have had their surgery performed by consultants doing fewer than 30 procedures per year.

We must take patient safety into account. Arguing a case purely to keep a local hospital open but abandoning the possibility of ensuring patient care is something all public representatives must consider. A further figure was of the 76 consultants who carried out breast cancer surgery in 2003. Some 45 had carried out fewer than ten procedures a year and 37 had performed five or less. When debating the need for specialised care and supervision, it is incumbent on the Government to ensure that if we are citing local hospitals that need to retain their services we take into account that it is vital for patient safety that the surgeons involved are up-skilled and at their best, and they will achieve this only by the level of treatment they carry out.

Groups coming before the Joint Committee on Health and Children have made me aware of MRSA and patient safety. The committee has discussed this regularly with the HSE and the families of those who have unfortunately been affected. The point has been made that we need a regulator or somebody in control, to whom reports are made, to ensure that the maximum safety measures and procedures are in place. It has also been said that the time has come for someone at local level to be responsible for enacting policies that ensure the MRSA bug can be eliminated. I support the amendment and what the Minister is trying to do. It is very important that she has made the point that it is not just her job to ensure we have the best standards by way of hospital construction and services; it is more important to ensure that staff providing those services are trained to the highest professional standards and can ensure the delivery of excellent services.

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